NPI | 1578082020 |
---|---|
Entity Type | Organization |
Authorized Contact | LISA NICOLE PRIMM VP Of Payer Relations 815-391-1000 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-0601-0052-A) |
Enumeration Date | 2017-09-15 |
Last Update Date | 2023-12-11 |